Pleomorphism of Legionella pneumophila

Legionella pneumophila (Lp), serogroups 1-6, was grown in vitro on a variety of media, in embryonated hens' eggs, and in guinea pigs. The morphology of the microbe was examined by light, immunofluorescent, and electron microscopy (transmission, scanning, negative staining). The configuration of all serogroups examined differed somewhat on agar media, in liquid media, and in vivo. Each serogroup of Lp showed pleomorphic features indistinguishable from the others. Except for filamentous forms, pleomorphism was least conspicuous on agar. By contrast, pleomorphism was most apparent in yeast extract broth, and it was detected by all of the morphologic techniques employed. Bacilli were seen most commonly, but the spectrum of forms was as follows: cocci, coccobacilli (short bacilli), medium bacilli, bacilli with terminal cocci, filamentous forms, and branches. Diplococci, branches, and stalks were only rarely seen, and the latter form was never visualized by immunofluorescence. In tissue samples from infected guinea pigs and embryonated hens' eggs, Lp was typically a short bacillus, but coccoid and coccobacillary forms were seen. Lp is clearly a pleomorphic bacterium, particularly when grown in yeast extract broth. The variety of forms described herein might provide clues to taxonomy, ecologic niche, and physiology of Lp.     

Increased frequency of steroid non-responsive nephrotic syndrome in Iranian children

During an eight year period, 66 Iranian children with nephrotic syndrome without renal failure were studied for their response to prednisone therapy. Twentysix (39·3%) of these were early steroid non-responsive. Of 40 responders, 70 per cent responded within the first 2 wk, 22·5 per cent within the second 2 wk, and 3 children during the next 4 wk of therapy. Two patients (3·03%) were steroid late non-responders.     

Possible mechanisms for observed pathophysiological variability in experimental spinal cord injury by the method of Allen.

Experimental spinal cord injuries were induced in dogs by dropping calibrated weights through a vented tube onto a small impounder resting on the surgically exposed cord. The motion of the impounder and the drop-mass were recorded by high-speed photography and the resulting data were compared to those obtained from a computer simulation of the dynamics of the injury mechanism. It is concluded that this method of induced spinal cord injuries may yield markedly different degrees of cord compression depending upon the parameters of the animal material and apparatus even when the gm-cm of impact energy is maintained at a constant value. Some approaches to standardization of this injury model are suggested.     

Best evidence topic report. Primary split skin grafts for pretibial lacerations

A short cut review was carried out to establish whether primary split skin grafting is better than simple wound edge approximation at reducing time to healing in patients with pretibial flap lacerations. A total of 72 papers were found using the reported search, of which one presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of this best paper are tabulated. A clinical bottom line is stated.     

Distribution of intraocular pressure in healthy Iranian individuals: the Tehran Eye Study

AIM: To provide data on the distribution of intraocular pressure (IOP) in an Iranian population. METHODS: Through a population based, cross sectional study, 4565 Tehran citizens were studied in the Tehran Eye Study. The findings from the participants (n = 3834) aged 10 years and older free of glaucoma diagnosis or suspicion who had undergone applanation tonometry examination are presented. All participants received a standardised protocol including applanation tonometry, fundus examination, demographic data, and an interview. IOP measurement was used to evaluate its distribution by age, sex, and some eye parameters. RESULTS: Mean (SD) IOP was 14.5 (2.6) mm Hg in the total population, 14.4 (2.7) in men, and 14.5 (2.5) in women. Mean (SD) IOP in people > or =40 years was 15.1 (2.9) mm Hg. IOP increased significantly with age and cup:disc ratio except for a fall in old age. This relation was also observed when individuals without diabetes or hypertension history were analysed. IOP increased with darker eye pigmentation except for blue/grey eyes. There was a non-linear increase in IOP from emmetropic to high myopic eyes. CONCLUSION: Age, iris colour, and cup:disc ratio were related to IOP but not to sex. The distribution of IOP in this study was different from various other studies in different geographical regions and it seems advisable to employ a geographical approach to normal IOP interpretation.     

Refractive outcome of silicone oil removal and intraocular lens implantation using laser interferometry

PURPOSE: To evaluate the refractive outcome of silicone oil removal and intraocular lens (IOL) implantation using laser interferometry. METHODS: Thirteen silicone oil-filled eyes of 12 patients were included in the study. IOL power calculation was performed using laser interferometry (IOLMaster V1.1; Carl Zeiss, Jena, Germany). All of these eyes underwent silicone oil removal and cataract extraction with IOL implantation. Post-operative refraction was evaluated. RESULTS: The mean deviation of the final post-operative refraction (spherical equivalent) was -0.30+/-0.91 D (range, -1.87 to +1.3) at 12 weeks. The mean axial length of the eyes was 22.99+/-0.84 mm (range, 22.07-25.24 mm). No major complications occurred intra- or post-operatively. CONCLUSION: Laser interferometry appears to be a feasible and satisfactorily accurate method to calculate IOL power in some silicone oil-filled eyes. Further studies comparing this technique to others are warranted.     

Serodiagnosis of sheep hydatidosis with hydatid fluid, protoscolex, and whole body of Echinococcus granulosus antigens

Diagnosis of hydatidosis is based on immunodiagnostic methods along with radiological and ultrasound examinations. A great number of immunological assays have been developed for detection of anti-hydatid cyst antibodies. The principal intermediate host of Echinococcus granulosus in most endemic regions of the world is sheep. Antibodies to various antigens are detectable in the sera of some, but not all infected sheep. The objective of the present study was to develop a specific and simple antigen-based ELISA method for diagnosis of hydatidosis in sheep with different (hydatid fluid, protoscolices, and whole body of E. granulosus) antigens. A total of 100 sera were collected from sheep with hydatidosis proven by inspection of hydatid-infested livers and lungs of the sheep slaughtered in Mashhad abattoir. Hydatid fluid and protoscolex were isolated from livers or lungs of sheep with hydatid cyst in sterile conditions. Whole body of E. granulosus was isolated from intestine of infected dogs. Sera samples were examined by ELISA with different antigens. The results of antibody detection by indirect ELISA, using different antigens, showed that the hydatid fluid was the most effective antigen of those assessed for detection of infection with hydatidosis in sheep. Findings of this study indicated that antibody detection assay is a sensitive approach for diagnosis of hydatid cyst in sheep.     

Infected Viabahn Stent Graft in the Superficial Femoral Artery

We present a case of an infected stent graft in the superficial femoral artery (SFA). A 67-year-old woman underwent excision of an infected Viabahn stent graft. At exploration there was no apparent artery around the majority of the stent graft, suggesting that the SFA had been autolysed.Infected stents and stent grafts are rare in the SFA position. The risk of infection is likely minimised with standard treatments including drainage of infection prior to stent graft placement and periprocedural antibiotic administration. Successful management will, in most cases, require excision of the stent graft and adjunctive arterial reconstruction, as necessary.